1. Field of the Invention
The present invention relates to a method for probing a specific site on the inner surface of a luminal organ within a body cavity, and to a method for holding the same luminal organ, during laparotomy or laparoscopic surgery.
2. Description of Related Art
A dot inking method employing India ink is carried out as a method for identifying microscopic lesions occurring on the inside of a luminal organ, such as the stomach or large intestine, during surgery via laparoscopy or laparotomy. In this dot inking method, India ink, which serves as a marker near the lesion, is injected from inside the luminal organ, to facilitate identification of the location of the lesion during either direct or indirect gross visualization of the outside of the luminal organ. A surgical method in which a lesion site occurring on the inside of the stomach is resected will now be explained as one example of this dot inking method.
First, several days to several weeks prior to the surgery, dot inking, which will serve as a marker during the resection, is performed near the site of the lesion. Specifically, an endoscope is inserted into the patient via the oral cavity, a needle is used to pierce the stomach wall from the inside near the lesion site, and India ink is injected. The injected India ink spreads out over the stomach wall, and assists in the direct or indirect gross confirmation of the lesion at the time of resection. During this procedure, care must be exercised to inject the ink to just the right depth to enable visual confirmation of the location of the spread India ink when viewing the stomach from the outside, without sticking the end of the needle completely through the stomach wall. If the needle penetrates through the stomach wall, then not only does the site of the lesion become unclear, but other internal organs may become coated with the India ink, resulting in a situation in which it is not possible to continue with surgery. Further, if the India ink cannot be injected so as to be visible from outside the stomach, then it is not possible to discern the lesion site, which can result in the all or part of the lesion being left behind following resection. In other words, the problem with this dot inking method is that it requires a high level of expertise to adjust the depth to which the needle is pierced, so that the dot inking can be carried out reliably.
Next, a conventional method for holding the lesion site as required during surgery will be explained. During surgery, the surgeon first searches for the location of the dot inking while using a laparoscope to visualize the outside of the stomach. Once the position of the dot inking is found, the positional relationship between the dot inking and the lesion site is taken into consideration, and metallic holding forceps are employed to hold the stomach and apply traction in a manner that will enable resection. Then, at a location on the stomach that is separated away from the area being held, a portion of the stomach (that includes the lesion site) is cut out using a procedure tool such as an automatic suturing device. In order that none of the lesion site is left behind in this method, it is necessary that the surgeon separate the lesion site and the holding position in this method. Additionally, since the surgeon must simultaneously carry out confirmation of the lesion site and the operation of holding the lesion, a high level of expertise is demanded.
As another method for resecting the stomach, there is a method in which, instead of using metallic holding forceps to hold the stomach in the vicinity of the lesion, the area of the stomach near the lesion is instead suspended using a thin metal rod in which a wire has been attached to the center, and the suspended area is resected. More specifically, this metal rod with attached wire is passed through the stomach wall by piercing the outside of the stomach with the rod in the vicinity of the lesion, which has been inked. Next, the wire attached to the metal rod is introduced to the outside of the abdominal cavity. Then, by applying traction from outside the body on the wire attached to the metal rod, the lesion site on the stomach can be suspended, and the lesion site, which is now easily resectable as a result of being suspended, is resected using an automatic incising and suturing device. This method requires a high level of skill to perform the operation of piercing the metal rod with the attached wire near the lesion from a position outside the body.